No one solution to address sanitation challenge in India, but behavioural change based on empirical data is the key, says National Consultation on Sustainable Rural Sanitation organised by CSE

Behavioural change happens when connection to health is made, but there is no mechanism to track the health impacts of sanitation

There is an urgent imperative to gather simple, measurable and credible on-ground data

Sikkim has achieved 100 per cent sanitation coverage through a combination of positive and negative pressure

CSE is setting up India’s first faecal sludge laboratory to test technologies for their effectiveness

October 6, 2016, New Delhi: There has been a huge political and financial investment on the Swachh Bharat Mission by Prime Minister Narendra Modi. The programme however, is straining to achieve the desired results. There is a struggle to bring in the much required behavioural change among people to use toilets – the backbone of the programme’s success. One of the key factors for this is the lack of credible on-ground data and the absence of institutionalised tracking mechanisms to measure the health benefits of impacts of proper sanitation, or the adverse impacts of the lack of sanitation.

While large-scale campaigns are essential to drive behavioural change, it is data that will connect the issue with health impacts and lead to impact on the ground. This emerged as one of the key takeaways from a National Consultation on Sustainable Rural Sanitation organised here today by Centre for Science and Environment (CSE). Currently, India does not have any mechanism for tracking water-borne diseases to shed more light about the progress on the sanitation programme.

Sunita Narain, director general, CSE, pointed out, “Our experience and our work in air pollution bears out that change happens when we make a connection to people’s health. And the issue needs to be handled differently for rural and urban areas. While in the urban milieu toilets have to be linked with disposal and treatment systems, in rural areas the priorities should be address the issue in the context of poverty, behavioural change by linking it with health, water availability, toilet design and waste disposal.”

The major issue with the current approach of the Swachh Bharat Mission, is the undue focus on construction of toilets. October 2, 2016 marked the completion of two years since the ambitious Swachh Bharat Abhiyan was announced from the ramparts of the Red Fort. One of the key promises made was to make India open defecation free (ODF) by 2019, by constructing toilets for 1.04 crore households, apart from 250,000 community toilets and 260,000 public toilets.

The reality on the ground however paints a dismal picture, with the government leagues behind in meeting its target. According to an analysis by the recently launched Hindi edition of Down To Earth magazine, which CSE helps publish, 82.3 million (or 823 lakh) toilets are yet to be constructed across India by October 2, 2019. This means the country needs to build 2.3 million (23 lakh) toilets every month – or a formidable 56 toilets every minute – to meet the target!

However, more than looking at this as just another failed government scheme, there is a larger picture that emerged during the national consultation, which brought together sanitation champions, failed states, technical experts/consultants, government officials, non-profits and donors. What emerged from the discussions was that apart from the obvious problems of poverty, lack of access to water, unavailability of land or lack of delivery of government programmes, the most critical issue was in terms of data-driven behavioural change in people.

Parameswaran Iyer, secretary, Ministry of Drinking Water and Sanitation said, “It took 30-40 years for people in the US to accept seat belts. In India, we are trying to compress the time frame in the context of sanitation. The challenge here is how does one scale up while maintaining quality and sustain the momentum after triggering such behavioural change.”

It is clear that there is no ‘one size fits all’ solution. Sikkim for instance is one of the successful states that achieved complete sanitation coverage. Haryana and Kerala excelled in their respective sanitation programmes, while states like Jharkhand, Bihar and Odisha failed miserably.

Rajkumar Yadav, district collector, South Sikkim, said, “We followed a strategy of putting two different types of pressure on people – one positive and the other negative. Positive pressure was put through campaigns and social messaging across sections of society. Negative pressure was applied by restricting and denying government benefits to those who haven’t constructed toilets or haven’t given up open defecation. This has helped create an overall positive impact.”

It is clear that a range of solutions is required, accounting for the varied geographies, socio-political setting and other factors in our diverse country – from technological solutions, to behaviour change, to scientific data gathering to policy interventions. “CSE has started the process of drawing out shit flow diagrams to understand the flow of faecal matter. We are also setting up India’s first faecal sludge laboratory to test technologies for their effectiveness,” said Narain. This will be a crucial first step towards such data gathering, especially in understanding sanitation in the rural context.

“Rural sanitation is more complex due to dimensions of poverty, and is much more extensive and inhuman, especially in the context of gender. World’s wicked problems are about gender -- whether cooking fuels, toilets or clean water,” added Narain.